Library FHIR Resource Proposal
This page documents a Pending FHIR Resource Proposal
Contents
- 1 Library
- 1.1 Owning committee name
- 1.2 Committee Approval Date:
- 1.3 Contributing or Reviewing Work Groups
- 1.4 FHIR Resource Development Project Insight ID
- 1.5 Scope of coverage
- 1.6 RIM scope
- 1.7 Resource appropriateness
- 1.8 Expected implementations
- 1.9 Content sources
- 1.10 Example Scenarios
- 1.11 Resource Relationships
- 1.12 Timelines
- 1.13 gForge Users
Library
The Library resource represents a shareable library of clinical logic, written in Clinical Quality Language (CQL). In addition to representing the metadata of the library, the resource has elements that expose the components defined within the library such as code system and value set references, named expressions, and parameters.
The actual content of the library is represented using the Attachment data type, and may either be referenced with a url to some CQL repository, or embedded as a base-64 encoded string. Either way, the content may be shared as a CQL text document, or, for a more computable reperesntation, as an Expression Logical Model (ELM) XML or JSON document.
The intent of the resource is to establish a standard mechanism to enable the sharing of clinical logic. The resource is a concrete realization of the Library type defined in the logical model of the HL7 Standard: Clinical Decision Support Knowledge Artifact Specification.
Owning committee name
Clinical Decision Support Work Group
Committee Approval Date:
2016-02-24 - Meeting Minutes
Contributing or Reviewing Work Groups
- Clinical Quality Information Work Group
- FHIR Management Group
- Service Oriented Architecture Work Group
FHIR Resource Development Project Insight ID
1234: FHIR-Based Clinical Quality Framework (CQF-on-FHIR)
Scope of coverage
A Library is a knowledge artifact that enables automated sharing of clinical logic. Because it is definitional in nature, it is not a patient-specific resource. The resource describes the metadata and public components of a CQL library and is flexible enough to be used for any discipline and locale. It is intended to be used by decision support and quality improvement content providers as a means of distributing a computable representation of clinical logic, as well as by health care delivery and reporting systems as a means of automtically integrating clinical logic.
Although Library resources are capable of being used independently (to distribute shared logic, for example), they will often be packaged with other knowledge artifacts such as DecisionSupportRule, OrderSet, and Measure. Note that those artifacts do not support the representation of logic directly, they use Library resources to describe any logic they require.
RIM scope
Resource appropriateness
Clinical quality measurement and improvement is a broad domain encompassing many aspects of overall healthcare. From decision support services and functionality to quality measurement and reporting, all these aspects make extensive use of logic to describe behavior and reasoning. Several existing HL7 Standards make use of Clinical Quality Language to represent this logic in various knowledge artifacts, and enabling that content to be published as a FHIR resource will extend the reach of that content. In addition, defining a Library resource will enable another potential role of a FHIR server as a CQL Repository.
Expected implementations
Multiple decision support and quality measurement content providers have expressed interest in using the Library resource to enable standards-based distribution of Clinical Quality Language libraries.
Content sources
- Clinical Quality Common Metadata Conceptual Model
- Clinical Decision Support Knowledge Artifact Specification
- Clinical Quality Language
- Health Quality Measure Format
- Decision Support Service
- Decision Support Service Implementation Guide
Example Scenarios
Exclusive Breastfeeding
Numerous studies document the benefits of exclusive breastfeeding for the first six months of life. A quality measure (CMS9v4) has been developed to attempt to determine the extent to which exclusive breastfeeding takes place. This measure has been translated into CQL and several derived decision support rules have been developed with the intention of ensuring that appropriate education regarding the benefits of exclusive breastfeeding is provided to all new mothers. In combination with the Measure and DecisionSupportRule resources, this codified clinical knowledge can be distributed to and integrated in various healthcare delivery systems to support improved outcomes for this guideline.
This scenario is a primary focus of the CQF-on-FHIR track at the May 2016 connectathon.
Resource Relationships
The Library resource is used by the following resources:
In addition, the resource makes use of the following common data types:
Timelines
May 2016 Ballot Cycle in support of the CQF IG.
gForge Users
brynrhodes
